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Organization
ASPEN FAMILY COUNSELING
Active
Organization
ASPEN FAMILY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY D ERATH LCSW (CLINIC DIRECTOR)
(608) 742-5020
Entity
Organization
Contact information
Practice address
2639 NEW PINERY RD, SUITE 1, PORTAGE, WI 53901-1110
(608) 742-5020
(608) 742-3641
Mailing address
2639 NEW PINERY RD, SUITE 1, PORTAGE, WI 53901-1110
(608) 742-5020
(608) 742-3641
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1066
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42202000
—
WI
01
—
570028
DEAN HEALTHCARE PROVIDER
WI
01
—
81145030
THE ALLIANCE PROVIDER #
WI
Enumeration date
05/02/2006
Last updated
07/21/2022
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